BRUCE VICKERS, CFCOsceola County Tax Collector

2501 E. Irlo Bronson Memorial Hwy, PO Box 422105 Kissimmee, Florida 34742-2105

Phone(407)742-4000 Fax (407)742-4009www.osceolataxcollector.org

OFFICIAL USE ONLY

Date Processed

Processor

Account #

APPLICATION FOR OSCEOLA COUNTY LOCAL BUSINESS TAX RECEIPT (formerly known as Occupational License)

(Please Print)IF YOUR BUSINESS IS LOCATED WITHIN UNINCORPORATED OSCEOLA COUNTY ZONING DEPARTMENT, APPROVAL WILL BE REQUIRED IN

ORDER TO ISSUE THIS BUSINESS TAX RECEIPT.Osceola County Ordinance 95-10, Section 1 states, “No person shall engage in or manage any business, profession or occupation within Osceola County…” unless exempt by county, state or federal law. Failure to comply with Osceola County Ordinance 95-10 may subject your business to additional costs including but not limited to court costs, attorney fees, administrative costs and penalties up to two hundred and fifty dollars ($250) per day.

1. Business Name:

A. List the name of the business: ___________________________________________________________________________B. If applicant is not using their legal name in the Business Name, please check one of the following:

� List the Fictitious/Corporation name number of the business as provided by the FL Dept. of State: _________________________________

� I WILL NOT engage in business until fictitious name/corporation registration number is received from Florida Department of State.

2. Business Location: Enter physical location of business (If this is a residential home and you rent or lease, a completed, “ Property Owner Affidavit “ is required and can be obtained from our website or any of our office locations)

Address ___________________________________________ City ________________________ State _______ Zip _____________

Telephone: (_______)__________________ Fax : (_______)__________________ Cell Phone: (_______)____________________

3. Location Boundary: Check only one � In Osceola County and limits of city listed in Section 2 � In Osceola County � Outside Osceola County

Parcel ID Number: (provided by the Tax Collectors office) ________________________________________________________________ **ANSWER THE FOLLOWING IF A RESIDENTIAL ADDRESS IS USED FOR THE BUSINESS**

Are materials, supplies, or equipment stored on the property? ___________ Does anyone, other than the occupant(s) work there? _____________

Do customers physically go to the address? ____________ Is there a sign located on the property? _____________

Did you obtain Home Occupational approval form the BOA? ____________ If “yes” what is the BOA number? _____________

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Name of Applicant (Owner or Principal): Enter the applicant’s legal name(s) & Corporation name(if applicable) below

First _____________________________ M. ________ Last _________________________________ Sur. ___________________

First _____________________________ M. ________ Last _________________________________ Sur. ___________________

Corporation Name:______________________________________________ Contact Name: __________________________________

Address ___________________________________________ City ________________________ State _______ Zip _____________

Telephone: (_______)__________________ Fax : (_______)__________________ Cell Phone: (_______)____________________

Mailing Address: Enter mailing address if different from physical location in Item 2 (Business Location)

Address ___________________________________________ City ________________________ State _______ Zip _____________

Social Security Number/Federal Tax ID Number: __________________________ Note: Sole Proprietors enter Social Security Numbers. Other Business Entities enter Federal Tax ID Number

(The Osceola County Tax Collector is required to collect Social Security numbers for the purposes of identification, and to fulfill reporting requirements in all phases of Statutory, Administrative, and Local Government Ordinance requirements.)

E-Mail Address: __________________________________ Bus. Website Address:_______________________________________

Type of Business: (Please be very specific) If the type of business you are engaging in is State Regulated, a copy of the corresponding state license, registration or certification is required to be attached to this application. (i.e. General Contractors, Restaurants, Auto Repair, etc.)

____________________________________________________________________________________________________________

Estimated Original Cost of the Equipment to be used in the Business $________________

List State License, Registration or Certification Number(s): __________________________________________________________________

Affidavit: Carefully review and sign the following affidavit (1) I, the undersigned, swear this application (including addendum and all other attachments) is true and correct. (2) I acknowledge and understand that a local county business tax receipt (previously referred to as an occupational license) is issued pursuant to this application is for the privilege of doing business in Osceola County and does not waive Florida

’s licensing, registration, and/or certification requirements, nor does it waive any other such requirements of any city, county,

state or federal authority that must be met prior to engaging in or entering into the activity, business, profession or occupation for which this application is being made.(3) I specifically acknowledge that a business tax receipt issued pursuant to this application does not indicate that the parcel of land upon which the business intends to operate is properly zoned for the activities in question and that it is the responsibility of the business to verify same with the appropriate zoning authority prior to commencing its activities or operations. (4) I also affirm that I, the business owner/principle of record indicated hereon, is in compliance or will comply with all federal, state and legal requirements.

Signature of Applicant: ___________________________________________ Date: _______________________ Receipt Fee:_________________ Once completed, please submit this application with payment to Bruce Vickers, Tax Collector. Use the above listed address when mailing in your application.

BUSINESS TAX RECEIPT CONSOLIDATED APPLICATION COMMERCIAL

Osceola County Community Development Division 1 Courthouse Square, Suite 1400

Kissimmee, Florida 34741 Phone No: (407) 742-0200 Fax No: (407) 742-0202

BUSINESS TAX RECEIPT CONSOLIDATED APPLICATION COMMERCIAL

REQUIREMENTS FOR SUBMITTAL OF APPLICATION

(1) Application for permit filled out in its entirety with correct parcel number and original notarized signature of license-holder or owner-builder

(2) Address Notification Form from Public Safety/911 Addressing (if applicable)

(3) Proof of Ownership (warranty deed, tax bill or Property Appraiser printout.)

(4) Notice of Commencement if cost of labor and materials is greater than $2500- (record and certify @ Courthouse –Recording Department)

(5) 1 Floor plan of current space being permitted.

(6) Lease agreement and /or notarized letter from land owner giving permission to pull permit.

(7) B.O.C.C. Tenant Occupancy Application Fee of $478

(8) Local Business Tax Receipt Fee 10/1 - 3/31 ……………$30.00

4/1 - 6/30 …………….$15.00 7/1 – 9/30 …………….$45.00

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I UNDERSPRINKDATE OEACH, M

WARNIMPRORECOApplicapermit to give public ragencie _____TYPE/ _____SIGNA

1. BUSINESS

2. PARCEL N

3. NAME OF B NAME OF T

TENANT/B

HOME PHO

TENANT/B

4. LANDOWN

LAND OWN

HOME PHO

LAND OWN

5. DESCRIBE

□ TENANT

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6. IF YOU AR EXISTING EXISTING PROPOSE

7. ESTIMATESQUARE FO

8. HEALTH D

City W

RSTAND THAT: SEPAKLERS, POOLS, SIGNOF FILING FOR THE PMAY BE ALLOWED B

NING TO OWNEOVEMENTS TO

ORDING YOUR “ation is hereby madand that all work wauthority to violate

records of Osceolaes. I certify that the

______________/PRINT NAME O

______________ATURE OF TENA

BU

ADDRESS: ___

NUMBER: ______

BUSINESS: ____

TENANT/BUSIN

BUSINESS HOM

ONE: __________

BUSINESS OWNE

NER’S NAME: __

NER’S ADDRESS

ONE:___________

NER’S EMAIL: _

E THE NATURE

T OCCUPANCY

_______________

RE CHANGING TAND PROPOSE

G USE: ________

ED USE: _______

D CONSTRUCTOOTAGE: LIV

DEPARTMENT I

Water and Sewer:

ARATE PERMITS/APNS, BOILERS, HEATEPERMIT, UNLESS BE

BY THE BUILDING OF

ER: YOUR FAILUYOUR PROPER

“NOTICE OF COde to obtain a permwill be performed to e the provisions of aa County. Additionae information conta

______________OF TENANT/BUS

______________ANT/BUSINESS

 

USINESS T

Osceo

Phone

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NESS OWNER: _

ME ADDRESS: __

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ER’S EMAIL: __

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S: _____________

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OF PROPOSED

– NO STRUCTU

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THE USE OF ANED USE.

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TION VALUATIOVING (AIR COND

INFORMATION

□ Yes □ No

***PLICATIONS MAY BE

ERS, TANKS, COOLEEFORE THEN A PERMFFICIAL FOR THE AP

URE TO RECORRTY. IF YOU INTOMMENCEMENTmit to do the work an

meet all provisionsany other applicablal permits may be reined in this permit a

______________SINESS OWNER

______________S OWNER

TAX RECEIC

ola County C1 Courth

Kissime No: (407) 7

_______________

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__________ CELL

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IMPROVEMEN

URAL CHANGE

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N EXISTING BUI

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ON (INCLUDE LDITIONED) ARE

:

Sep

******* NE REQUIRED FOR ELRS, etc. THIS PERMIMIT HAS BEEN ISSUE

PPLICATION, PROVID

RD A “NOTICE OTEND TO OBTAT”. nd installations as is of laws and ordine state or local codequired from other application is accur

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IPT CONSOCOMMERCCommunity Dhouse Squaremmee, Flori742-0200 Fa

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L PHONE: _____

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L PHONE: _____

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NTS:

ES______________

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ILDING OR STR

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LABOR AND MAEA ___________

ptic System: □ Y

NOTICE **LECTRICAL, PLUMBIT APPLICATION SHAED. ONE OR MORE E

DED THE EXTENSION

OF COMMENCEAIN FINANCING,

indicated. I certify tances regulating co

des and/or ordinancgovernmental entitrate and true.

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OLIDATEDCIAL Developmene, Suite 1400ida 34741 ax No: (407)

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DIVISION: _____

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RUCTURE PLEA

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ATERIALS).$___ NON – LIVING

Yes □ No

**********ING, MECHANICALS ALL BE DEEMED TOEXTENSIONS OF TIMN IS REQUESTED IN

EMENT” MAY RE, CONSULT WIT

that no work or instconstruction in this jces. Additional restties such as water

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D APPLICA

nt Division 0

) 742-0202

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_________ FAX: _

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ASE LIST THE

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Public W

* (i.e. heating, air cond

O HAVE BEEN ABANME, FOR PERIODS O

WRITING AND JUST

ESULT IN YOURTH YOUR LEND

tallation has commjurisdiction. The gratrictions applicable management distri

______________(DATE)

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ATION

_______________ (STATE)

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_______________ (STATE)

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Well: □ Yes □

itioning, coolers, etc.)DONED SIX (6) MON

OF NOT MORE THAN TIFIABLE CAUSE IS D

R PAYING TWICER OR ATTORN

enced prior to the anting of a permit d to this property maicts, state agencies

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______________ (ZIP)

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________________ (ZIP)

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□ No

,DRYWALL, FIRE THS AFTER THE NINETY (90) DAYS

DEMONSTRATED.

CE FOR THE NEY BEFORE

issuance of a does not presume ay be found in the s, or federal

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